Taniguchi, M., Tateuchi, H., Ibuki, S., & Ichihashi, N. (2017). Relative mobility of the pelvis and spine during trunk axial rotation in chronic low back pain patients: A case-control study. PloS one, 12(10), e0186369. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5645112/
Relative mobility of the pelvis and spine during trunk axial rotation in chronic low back pain patients: A case-control study
Regardless of the generation observed, chronic low back pain has been a continuous health concern. Previous studies observed by Taniguchi, Tateuchi, Ibuki, and Ichihashi (2017) have illustrated that trunk rotation may increase the risk of injury to the low back. In order to conduct an experiment on trunk rotation, we must first explore the biomechanics deemed dangerous and generates a risk of injury. Trunk rotation occurs when the pelvis rotates, assisted by slight rotation of the spine. The lumbar spine contributes very little rotation, as opposed to the thoracic spine that has wider degrees of freedom. The researchers believe that any excessive spinal rotation at the end of a range of motion may increase the risk of injury (Taniguchi, et al. 2017). Movement that generates trunk rotation may also perform coupled motion, which is “the rotation or translation of a vertebral body about or along 1 axis that is consistently associated with the main rotation or translation about another axis (Taniguchi, et al. 2017).”
Researchers Taniguchi, Tateuchi, Ibuki, and Ichihashi (2017) conducted a control-case study on trunk axial-rotation in efforts to observe and analyze the three-dimensional kinematic changes. The researchers also utilized observations to compare the difference of rotational mobility and coupled motion of patients with chronic low back pain and those without (Taniguchi, et al. 2017). The hypothesis of the study was that participants with chronic low back pain had different movement patterns versus a difference in maximal range of motion in the transverse plane and rotation consisting of excessive spinal motion coupled in those with chronic low back pain (Taniguchi, et al. 2017). The study conducted by Taniguchi, Tateuchi, Ibuki, and Ichihashi (2017) consisted of 30 volunteers, 15 being participants with nonspecific chronic low back pain. The other 15 being those without CLBP that matched the CLBP group in age and sex. Participants were involved in sport activities and current students at Kyoto University. The subjects with chronic low back pain were selected based off of three concepts, having a history of low back pain with “an intensity greater than 30 mm on the visual analog scale (VAS) (Taniguchi, et al. 2017)” , more than 3 months of continuous pain, and having the ability to complete the provided movement task. 18 participants continued through the screening process through completing a novel questionnaire and individuals with pain in the buttocks, lumbosacral region, and upper leg, without any specific nerve root symptoms. 3 of the 18 participants were discovered to have been diagnosed with disk herniation, eliminated them from the study, and bringing the CLBP group to the 15 subjects listed previously (Taniguchi, et al. 2017). During testing protocols, participants were instructed to remain in a standing position, with their hands on their abdomen and a 10-degree toe-out angle. The researchers designated that the calcanei be separated a distance equal to the length of the participant’s foot. Data was collected while the individual was in the standing position for three seconds. The participant was then instructed to complete trunk rotation to the left side, return back to the neutral standing position, rotate to the right side, and then finally back to the neutral standing position all in 4 seconds. The researchers utilized a motion system and a force plate to record the three-dimensional kinematics. Thoracic and pelvic segments included markers in which created an X, Y, and Z axis grid to analyze angles in reference to the gobal frame. During the analysis of angle measurements, any positive values represented lateral flexion, anterior tilt, and axial rotation to the left side for the pelvis and thorax (Taniguchi, et al. 2017). In comparison of the two groups, there was no significant different in the rotational range of motion of the pelvis, thorax, and spine. Although there weren’t significant differences, there was an interaction between rotational range of motion of the pelvis and spine and groups (F = 4.57, p = 0.04). The spine/pelvis ration in the healthy subjects was highly less than the chronic low back pain group (CLBP; 0.50 ± 0.10 Control; 0.41 ± 0.12, p = 0.04). The results at maximal rotation and 50% rotation were similar. The gathered observation and evaluation indicate an increase in spinal rotation during trunk rotation of patients in the CLBP group (Taniguchi, et al. 2017). With understanding that the goal of the study was to find evidence that individuals with chronic low back pain had different movement patterns versus a difference in maximal range of motion in the transverse plane and rotation consisting of excessive spinal motion coupled in those with chronic low back pain, we can then compare this with the established findings of the study. The study conducted by Taniguchi, Tateuchi, Ibuki, and Ichihashi (2017) concluded with the result of CLBP subjects possessing an increase in spinal rotation during trunk rotation. With an increase in spinal rotation, more likely coming from the lumbar region, researchers can then begin to observe mechanics within the spine itself in efforts to examine compensation of movement from any particular region to another. When the body begins to compensate in movement patterns, overtime we then start creating structural or muscular imbalances.
Reflection & Application
Utilizing results of the provided study, we then dive into the possibilities of application for future studies and program creation among populations. Research that follows the given study could examine the degrees of freedom between each vertebra of the lumbar in comparison to the thoracic spine. The range of motion could not only be compared between the different regions of the spine in the same subject, but also compared across the board with both individuals with chronic low back pain and those without. The issue might originate from excessive movement throughout the lumbar, with lack of ROM in the thorax. When specifying the imbalances located throughout the spine, researchers can then begin to evaluate the best possible rehabilitation and therapy methods for the biomechanical issue.
Taniguchi, Tateuchi, Ibuki, and Ichihashi’s study (2017) was insightful and specific to the nature of which biomechanical movement is being observed and analyzed. Although there was a sum of participants, I do believe the study needs to be expanded with more subjects under each study group. I also believe that the study should be taken one step further down the road with analyzing the lumbar vertebrae individually for degrees of freedom and range of motion imbalances. This would drastically increase the duration to collect the study results, but could either be broken up into two studies or just sacrifice not publishing as quickly and gather more data. To me overall, the study was insightful and helps me begin to ask questions on why there might be an increase in spinal rotation when individuals have chronic low back pain. Does the pain originate from the excessive movement? Or does the excessive movement originate from muscular and skeletal flaws from other regions? I chose this study because I like understanding rotational health of the spine, in which I can use this knowledge to further enhance my injury prevention programs with fire departments. Injury prevention programs include implementing recovery, mobility, and movement prep sessions that encourage the highest level of performance possible at their given fitness level. A strong wellness program examines and influences the improvement in all aspects of fitness.
Author: Hussien Jabai
Contact Info: Hussien@jabaiperformance.com